Relationship between Small Intestinal Bacterial Overgrowth and Peripheral Blood ET, TLR2 and TLR4 in Ulcerative Colitis

Abstract

Ulcerative colitis, a common inflammatory bowel disease, is often chronic and recurrent. 1 The pathogenesis of ulcerative colitis is currently unknown. A study have suggested that ulcerative colitis is the result of interactions between intestinal microorganisms and the intestinal immune system. 2 The composition of the intestinal microbiota may affect the susceptibility to ulcerative colitis. 3 Small intestinal bacterial overgrowth (SIBO) refers to the displacement of the microflora in the distal intestine into the small intestine due to various reasons, causing inflammation of the small intestinal mucosa, disruption of permeability, and damage to villus, and it mainly manifests as abdominal pain, abdominal distention, diarrhea, small bowel motility disorders, and other symptoms. 4,5 Studies have confirmed that SIBO is closely related to diseases such as non-alcoholic fatty liver disease, cirrhosis, diabetes, irritable bowel syndrome, and chronic pancreatitis. [6][7][8] Lactulose hydrogen breath test (LHBT) has the advantages of being cheap, simple, and non-invasive. 9 In this experiment, LHBT was used to measure SIBO. At present, there have not been many reports on the correlation between ulcerative colitis and SIBO. The tolllike receptors (TLRs), as important bridges connecting innate and adaptive immune systems, are abundantly expressed on the surface of peripheral blood mononuclear cells (PBMCs). 10 Endotoxin receptors TLR2 and TLR4 are important receptor molecules in the host's immune response against pathogenic microorganisms, exerting an important role in the initiation of the endotoxin-induced inflammatory response. 11 Previous studies have revealed that the incidence of SIBO is higher in patients with non-alcoholic fatty liver, and the endotoxin level and TLR4 expression in patients

Rifaximin Improves Liver Functional Reserve by Regulating Systemic Inflammation

“…Considering the strong correlation between albumin and inflammatory cytokines, CAR is a useful indicator for patients with cirrhosis. Regarding the effect of rifaximin on CRP and CAR, rifaximin improves CRP levels in small intestinal bacterial overgrowth [ 56 ], whereas no studies have examined CRP or CAR in cirrhosis. However, considering that rifaximin improves inflammatory cytokines such as IL-6 and TNF-α [ 46 , 47 , 48 , 49 ], there is the possibility that CRP, produced by these cytokines, is also improved.…”

Patients with breath test positive are necessary to be identified from irritable bowel syndrome: a clinical trial based on microbiomics and rifaximin sensitivity

“…Some studies [21,[34][35][36] suggest that SIBO may aggravate the inflammation status in patients with obesity, Crohn's disease, cirrhosis, or even Parkinson's disease. Interestingly, in this study, for IBS-D patients in BT-positive group, their ileum rather than systemic immunity is activated.…”

The Experimental Exploration of TCM Theory “Treating the Same Disease with Different Approaches” on an Ulcerative Colitis Model

“…Under normal circumstances, the expression of TLR4 is extremely sparse. However, TLR4 is abundantly expressed in epithelial cells and lamina propria cells of colon mucosa in UC patients [ 20 ]. When TLR4 ligand such as LPS binds to TLR4 of abnormal expression, NF- κ B was activated through MyD88, the primary immune response protein of bone marrow differentiation [ 21 , 22 ].…”